It has been 44 years since the country last won the international singing competition.
Represented by Duncan Laurence, The Netherlands nudged into first place ahead of Italy, who had 465 points.
The UK's Michael Rice came last with a total of 16 points.
Laurence's stripped back performance of Arcade saw him play piano under a spotlight on an otherwise empty stage.
"To dreaming big," Laurence said after his win was announced. "This is to music first," he added.
The Netherlands performed well in the judges' votes, which had seen the country jostle with Italy, North Macedonia and Sweden for first place.
Some high votes from the general public for countries further down the list had looked to potentially steal the crown from the front runners.
Although the public's vote was unable to boost Switzerland and Norway into the winning position, they were able to rise into fourth and fifth place with 360 and 338 points - behind Russia who came in third with 369 points.
Sweden, who had been top of the board following the judges' vote with 239 points ended sixth with 332.
Laurence's win means the contest will be held in The Netherlands next year.
This year it was held in Tel Aviv, Israel, following Netta's victory in 2018, which sparked some backlash as some argued the country's conflict with Palestinians should not be endorsed.
Madonna performed during the show, despite calls for her and other stars to boycott the event.
She sang her 1989 hit Like A Prayer, with a 35-strong choir, and her new single Future, alongside American rapper Quavo.
© Sky News 2019